Dental health on decline for Chicago's needy

Dr. Thomas Skiba, left, helps a third-year dental student during a surgery last week at the University of Illinois at Chicago College of Dentistry clinic. (Abel Uribe, Chicago Tribune)

As more than 30,000 dental experts descend on McCormick Place for their winter meeting this week, a new report issues a stark warning: The Chicago area's dental safety net — the oral care it provides to underserved patients — "is in the midst of collapse."

From 2006 to 2011, more than a quarter of the region's low-cost dental clinics were shut, according to a 30-page white paper released Thursday by the Chicago Dental Society. The report details how the local availability of dental treatment has declined for the neediest patients, leading to what one dentist calls a "perfect storm of an oral health crisis."

They have "almost nowhere to go" at this point, said Dr. Susan Becker Doroshow, secretary of the dental society. "The path for them is already irreversible."

Most factors cited in the report could apply to any municipality — strained budgets, fundamental misconceptions about oral care and shrinking income thanks to stubborn unemployment. But the dental safety net in Cook County and Chicago is especially vulnerable, according to oral health advocates.

"The economy has hit our area hard," Doroshow said. "When people are strapped financially, they take away the things from their budget they think are the easiest to postpone."

In 2011, more than half of Chicago-area residents surveyed by the dental society said they put off dental treatment in the past year because they couldn't afford it.

Delaying oral care could be disastrous. Every year, dental health-related illnesses are responsible for 20.5 million days of missed work and 51 million hours of missed school, according to the U.S. Department of Health and Human Services.

Last spring, Illinois lawmakers approved a $1.6 billion cut to the state's Medicaid program, resulting in what many dentists describe as an "emergency-only" program for adults. The remaining service, they say, does nothing to curb the underlying problems that can often lead to emergency treatment.

Today, Illinois ranks 48th in the nation for Medicaid reimbursement, with the state paying back Medicaid dentists just over half what it gives hospitals and pediatricians.

Although the report notes neither Cook County nor Chicago currently has a dental care director, the city Health Department has taken steps to increase access, partnering with Chicago Public Schools to provide preventive treatment to about 100,000 students.

Dr. David Miller, Illinois' chief dentist and a former state representative, said the report illustrates the increasing difficulty of advocating for oral care.

"When I was there, it was a lot easier," Miller joked about his time in the Illinois General Assembly, noting dental authorities have to "educate legislators continuously" to keep dentistry-related funding off the chopping block.

For Samah Onaissi, 26, the importance of preventive care became obvious when he walked into a University of Illinois at Chicago dental clinic four months ago. The master's degree student at the Illinois Institute of Technology recently returned from visiting family in Colombia and Lebanon and realized he hadn't seen a dentist in more than six months.

"So I didn't have any evaluation or assessment for a long time," he said during an appointment Wednesday at the UIC College of Dentistry clinic, which is run by undergraduate students. "Coming here, initially, was because of an emergency. Now I'm here regularly."

The decline in low-cost dental clinics has turned Illinois' dental schools like UIC into "de facto clinics," according to the report. Dr. Michael Santucci said he's "very happy to accept" underserved patients at the UIC clinic, but not every Illinois resident has that luxury.

The state has three dental schools: two in the Chicago area and one about 300 miles away near Illinois' southwestern border with St. Louis.

"We can see patients from the Chicago area, but what about patients from Rockford or Peoria?" said Santucci, who is on the dental society's Access to Care committee. "Those patients are not going to have dental care."

The society points to its fundraising arm as one model of propping up the safety net. The Chicago Dental Society Foundation used public and private donations to open a free clinic in Wheaton along public-transit routes that will offer preventive treatment, not just emergency operations, starting next month.

Still, dental professionals agreed that one clinic can't change the political mind set that oral care is "fluff in the budget," as Doroshow puts it.